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Part I Basics
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Skin Analysis
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Your Skin Analysis Survey
Part I Basics
Part II Dark Spots
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Your Skin Analysis
1. Do you have unprotected sun exposure?
Often or every day
Sometimes
Used to but I apply sunscreen diligently now
Rarely or never
2. Have you ever used tanning beds or sun lamps in an attempt to get a tan?
Yes, often and still doing it
Often in the past but not doing it anymore
Yes, but less than five times
Never
3. What is the color of your skin?
Light (I am a Caucasian with very fair skin.)
Medium Light (I am a Caucasian with medium light skin or I am of Asian, Latino, or Middle Eastern descent with light skin.)
Brown or Olive (I am of Asian, Latino, Middle Eastern, or African descent)
Dark or Black (I am of African descent or other ethnicities with very dark skin)
4. Have you ever smoked?
Yes, I have smoked for 5 years or longer
Yes, less than 5 years
Only a few times over my life
No
5. Do you have dry skin conditions?
Yes, my skin is dry and thin
Yes, my skin has dry patches
Only once in while
No
6. Do you live in a place with air pollution?
Yes, serious air pollution
Yes, but not serious
Only slightly
No
7. Have you ever had a tan from sun exposure, whether intentionally or not?
Very often
Sometimes
Only a few times
Rarely or Never
8. Do you see wrinkles on your face?
Yes, both fine and deep wrinkles
Wrinkles around the eyes and mouth and more when I smile
Only when I smile
No, not even when I smile
9. Which of the following best describes your parents?
They both look much older than their age
One parent looks much older than his/her age
They both looked their age
They both look much younger than their age